Distinctive Convergence Eye Movements in an Acquired Neurosensory Dysfunction.

Carey D Balaban,Alexander Kiderman,Mikhaylo Szczupak,Michael E Hoffer,Bonnie E Levin

doi:10.3389/fneur.2020.00469

Abstract

In late 2016, diplomats in Havana, Cuba, began presenting with a unique symptom complex after perceiving a strange noise and/or feeling a pressure field in their domicile. This report is a retrospective, quantitative analysis of video-oculography data of pupillary light reflex performance and binocular disparity-driven eye and pupil movements during the acute time period after the reported exposure. The patterns of response in these 19 individuals are markedly different than those seen in a group of individuals with the usual acute mild traumatic brain injury (17 subjects) and from 62 control subjects (21–60 years old) with no injury. Non-linear least squares regression was used to estimate the model parameters from the eye movement and the pupil measurements (1). Linear discriminant analysis was then used to identify a classifier for an objective discrimination of the groups with >91% accuracy and no confusion between the acute neurosensory findings among the members of the Havana diplomatic community and the subjects with acute mild traumatic brain injury. This pattern difference in eye and pupil behavior may be a useful screen to help objectively distinguish blunt trauma from Havana-type effects in the future and to guide the affected individuals to appropriate care.

Highlights

Complaints of sudden-onset tinnitus, ear pain, and dizziness emerged in late 2016 to early 2017 among diplomatic personnel and their families in Havana, Cuba
The analysis of de-identified, retrospective data was approved by the University of Pittsburgh Institutional Review Board and the institutional review board (IRB) at the University of Miami and the Madigan Army Medical Center
They provided data with written informed consent under protocols approved by the IRBs at the University of Miami and the Madigan Army Medical Center and in accordance with the Declaration of Helsinki

Summary

Introduction

Complaints of sudden-onset tinnitus, ear pain, and dizziness emerged in late 2016 to early 2017 among diplomatic personnel and their families in Havana, Cuba. These affected individuals often reported hearing a loud, high-frequency, localized sound, and were under the impression that it could follow them in a room. Examinations and formal testing at the University of Miami in the acute to the subacute time frames found had objective evidence of both an otolithic abnormality and of cognitive dysfunction in a group of 25 individuals [2]. When 21 exposed individuals were examined in a more chronic time frame (average of 201 days post-perception of exposure), 20 subjects reported persistent symptoms and signs that resembled the aspects of mild traumatic brain injury [3].

Methods

Results

Discussion

Conclusion